British Journal of Renal Medicine - 2008

Comment: The hazards of modifying risk – lessons from the heart
John Bradley
pp 3-3
Risk management is central to running a modern dialysis unit, and Nicholas Hoenich and Rob Levin identify some of the equipment-related and human errors that can occur during treatment
Encapsulating peritoneal sclerosis: a review
Aldo Riquelme, Paul Mead, Jean Melville and Farshid Fallahi
pp 4-7
Encapsulating peritoneal sclerosis (EPS) is an uncommon but serious complication of long duration peritoneal dialysis (PD). The end result of this process is either partial or complete small bowel obstruction. The early clinical features, however, are non-specific and often not recognised until complications develop.
Audit of costs associated with the use of cinacalcet
Kate Shiell, Raj Brhigu Sood, Edward J Kingdon and Stephen G Holt
pp 8-11
The current treatment targets for bone mineral metabolism in renal patients suggested by UK (Renal Association [RA]) and US (Kidney Dialysis Outcomes quality Initiative [KDOQI]) guidelines are difficult to achieve. Approximately one-third of UK haemodialysis (HD) patients’ results lie outside RA guidelines.
Controlling serum phosphate in the predialysis patient
Nicki Ruddock and Graham Warwick
pp 12-14
Hyperphosphataemia is recognised as an important risk factor for many adverse outcomes in dialysis patients, including vascular calcification, calciphylaxis, secondary hyperparathyroidism (SHPT) and mortality. Retention of phosphate occurs much earlier in the course of chronic kidney disease (CKD), with serum phosphate concentration increasing when estimated glomerular filtration falls below 30 ml/min/1.73 m2 (CKD stage 4).
What I tell my patients about IgA nephropathy
Jonathan Barratt
pp 15-18
IgA nephropathy is a type of kidney disease that affects the very fine filters (glomeruli) of the kidneys. In IgA nephropathy, a protein normally found in the blood, IgA (immunoglobulin A), deposits in these filters and causes inflammation and damage to the glomeruli (glomerulonephritis). IgA is a type of antibody – also known as immunoglobulin – whose normal function is to protect the body from infections; however, for some reason, in IgA nephropathy, IgA proteins have a tendency to deposit in the kidneys and cause damage.
Electron microscopy: its future in renal disease
Alan Curry and Lorna J McWilliam
pp 19-20
Once a renal biopsy has been performed and delivered to the laboratory, the diagnostic process involves light microscopy (LM) – haematoxylin and eosin (H&E) plus special stains, immunofluorescence (IF) and/or immunoperoxidase (IP) microscopy, and electron microscopy (EM). EM remains a fundamentally important and essential part of this diagnostic process, as outlined in several publications.
Are there still risks in a modern dialysis unit?
Nicholas A Hoenich and Rob Levin
pp 21-24
Haemodialysis provides life support for the patient with end-stage renal disease. It may be performed in hospital, the patient’s home or in satellite units which may or may not be attached to a medical facility. Haemodialysis requires medical, nursing and technical staff to interact with, and use, complex technical equipment. While haemodialysis is one of the success stories of modern medicine, machine-related faults, operating errors and other problems with patient safety can occur during treatment.
Introducing befriender services to a renal unit
Michelle Webb and Lizzy Bovill
pp 25-26
Enshrined in the National Service Framework for Renal Services is the requirement for all patients to be provided with high-quality, culturally appropriate and comprehensive information, and an education programme tailored to their individual needs.
Renal action learning sets: a report on progress so far
Mike Pedler, Rachel Lewis, Stephen Mousdale, Colin H Jones, Nick Pritchard, David V Milford, David Fisher and Stephen D Marks
pp 27-31
Action learning is a way of helping people to make improvements to the services they provide and to the performance of their organisations. Action learning starts from the premise that people learn best when they plan and take action on real-life work issues by working collaboratively in small groups called action learning sets. The learning sets also help members to reflect on their actions, learn from them and spread this learning into the wider system. Very simply, it is about taking action for change on challenging issues and learning from that process.

The British Journal of Renal Medicine was previously supported by Baxter Healthcare from 2011 to 2013, by Sandoz in 2011, by Shire Pharmaceuticals from 2006 to 2011, by Ortho Biotech and Shire Pharmaceuticals in 2005, by Ortho Biotech from 2000 to 2005 and by Janssen Cilag from 1996 to 2000.

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ISSN 1365-5604 (Print)  ISSN 2045-7839 (Online)